Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jun 16, 2021; 9(17): 4303-4309
Published online Jun 16, 2021. doi: 10.12998/wjcc.v9.i17.4303
Complete recovery of herpes zoster radiculopathy based on electrodiagnostic study: A case report
Hyeon Seong Kim, Ji Won Jung, You Jin Jung, Young Suck Ro, Si-Bog Park, Kyu Hoon Lee
Hyeon Seong Kim, Ji Won Jung, Si-Bog Park, Kyu Hoon Lee, Department of Rehabilitation Medicine, Hanyang University Hospital, Seoul 04763, South Korea
You Jin Jung, Young Suck Ro, Department of Dermatology, Hanyang University Hospital, Seoul 04763, South Korea
Author contributions: Kim HS (the first author) interpreted the data and drafted the manuscript; Jung JW and Jung YJ contributed to data analysis; Ro YS and Park SB contributed to study design; Lee KH (the corresponding author) was responsible for manuscript revision for important intellectual content; All authors issued final approval for the version to be submitted.
Informed consent statement: Informed written consent was obtained from the patient for publication of this case report and any accompanying images.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Kyu Hoon Lee, MD, PhD, Professor, Department of Rehabilitation Medicine, Hanyang University Hospital, 222-1, Wangsimni-ro, Seongdong-Gu, Seoul 04763, South Korea. dumitru1@hanyang.ac.kr
Received: January 9, 2021
Peer-review started: January 9, 2021
First decision: January 24, 2021
Revised: February 3, 2021
Accepted: March 24, 2021
Article in press: March 24, 2021
Published online: June 16, 2021
Processing time: 137 Days and 6.7 Hours
Abstract
BACKGROUND

Herpes zoster is a painful infectious disease caused by the varicella zoster virus. Herpes zoster radiculopathy, which is a type of segmental zoster paresis, can complicate the disease and cause motor weakness. This complication should be considered when a patient with a rash complains of acute-onset motor weakness, and the diagnosis can be verified via electrodiagnostic study.

CASE SUMMARY

A 64-year-old female with a history of asthma presented to the emergency department with stabbing pain, an itching sensation, and a rash on the right anterior shoulder that had begun 5 d prior. Physical examination revealed multiple erythematous grouped vesicles in the right C4-5 and T1 dermatome regions. Because herpes zoster was suspected, the patient immediately received intravenous acyclovir. On the third hospital day, she complained of motor weakness in the right upper extremity. Magnetic resonance imaging of the cervical spine revealed mild intervertebral disc herniation at C4-C5 without evidence of nerve root compression. On the 12th hospital day, electrodiagnostic study revealed right cervical radiculopathy, mainly in the C5/6 roots. Six months later, monoparesis resolved, and follow-up electrodiagnostic study was normal.

CONCLUSION

This case emphasizes that clinicians should consider the possibility of post-herpetic paresis, such as herpes zoster radiculopathy, and that electrodiagnostic study is useful for diagnosis and follow-up.

Keywords: Herpes zoster; Radiculopathy; Electrodiagnosis; Varicella zoster virus; Monoparesis; Case report

Core Tip: Herpes zoster is caused by reactivation of latent varicella zoster virus and characterized by clustered vesicles with neuralgic pain. We present a rare case of herpes zoster radiculopathy and accompanying severe motor weakness. The patient was diagnosed via electrodiagnostic study, and complete recovery was confirmed through follow-up electrodiagnostic study. This case emphasizes that clinicians should consider the possibility of post-herpetic paresis, such as herpes zoster radiculopathy, and that electrodiagnostic study is a helpful tool for diagnosis and follow-up.